Significance of Fibro Scan examination in hepatitis B virus-infected patients with normal ALT
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摘要:
目的应用瞬时弹性波扫描仪(FS)对ALT正常的HBV感染者进行筛查。方法收集2012年11月-2013年11月在辽宁省人民医院和中国医科大学盛京医院就诊的125例患者,全部进行肝活组织检查,并同时应用FS测定肝脏硬度值(LSM),以肝活组织检查病理学炎症分级为标准,以G1组为对照,绘制受试者工作特征曲线(ROC),选定cut-off值。计量资料多组间比较采用Kruskal-Wallis H检验,各组间的两两比较采用Bonferroni法检验。结果同一肝纤维化分期HBV感染者的LSM随着肝组织炎症程度的加重而升高,在S0S2肝纤维化分期中的不同炎症组间比较差异均有统计学意义(P值均<0.001),但g0组与g1组lsm差异无统计学意义(p>0.05)。G2级及以上肝脏炎症,FS诊断的ROC曲线下面积为0.784,根据ROC曲线选定的cut-off值为8.64 k Pa,敏感度为78.6%,特异度为69.2%。结论对于ALT正常的HBV感染者,通过应用FS检查,明确是否需要进一步检查及治疗。对于LSM≥8.64 k Pa的患者应该进行肝活组织检查,LSM&...
Abstract:Objective To screen hepatitis B virus( HBV)- infected patients with normal alanine aminotransferase( ALT) using Fibro Scan( FS). Methods Liver biopsy was done for all the 125 patients who were admitted to our hospitals from November 2012 to November 2013,and FS was performed for the liver stiffness measurement( LSM). Using the pathological inflammation grade from liver biopsy as a classification standard and G1 group as a control,a receiver operating characteristic( ROC) curve was plotted and the cut- off value was determined.Comparison of continuous data between multiple groups was made by Kruskal- Wallis H test,and comparison between two groups was made by Bonferroni test. Results The LSM of HBV- infected patients with the same stage of liver fibrosis was found to increase with the progression of liver inflammation; there were significant differences in LSM between groups with different grades of inflammation in each stage of liver fibrosis( S0- S2)( P < 0. 05),but no such differences were found between patients with inflammation grades G0 and G1( P > 0. 05).For≥G2 liver inflammation,the area under the ROC curve of FS was 0. 784,and the cut- off value determined by the ROC curve was 8. 64 k Pa,with 78. 6% sensitivity and 69. 2% specificity. Conclusion For HBV- infected patients with normal ALT,FS should be performed to decide whether further examination and treatment are needed. For patients with LSM≥8. 64 k Pa,liver biopsy should be performed; while for those with LSM < 8. 64 k Pa,regular examination is recommended.
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Key words:
- Fibro Scan /
- hepatitis B virus /
- alanine transaminase
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